Myocardial infarction associated with pregnancy is a relatively rare event, usually related to maternal risk factors for ischemic heart disease such as hypertension and diabetes mellitus. Coronary artery dissection represents an even more uncommon event and generally occurs in peripartum women without predisposing risk factors. A 31-year-old patient's postpartum course was complicated by the development of probable acute fatty liver of pregnancy followed by myocardial infarction and coronary artery dissection. The acute fatty liver of pregnancy and the cardiac event in our patient may both be vasospastic events related to vascular hypersensitivity.